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目的探讨老年AECOPD患者中血管内皮生长因子(VEGF)水平的诊断价值及其与急性生理学与慢性健康状况(APACHE III)评分之间的相关性。方法收集、观察60例老年AECOPD患者,30例COPD稳定期患者,30例健康老年人;入院后24 h内行、超敏C-反应蛋白(his-CRP)、降钙素原(PCT)、白细胞(WBC)、中性粒细胞百分比(N)等相关检查;并记录入院24 h内及治疗第8天APACHE III,治疗前后动态观察VEGF值及APACHE III评分变化。结果①与超敏C-反应蛋白、白细胞、降钙素原等相比,VEGF作为诊断AECOPD的单一指标是最好的。②治疗后VEGF值(109.16±50.85)、APACHE III值(26.45±3.37)明显低于治疗前(明显改善)VEGF值(213.91±72.00)、APACHE III(42.35±4.22)(P<0.05),VEGF水平与APACHE III评分明显相关。结论血清VEGF是诊断慢性阻塞性肺疾病急性加重的一个较好指标,判别效果高于PCT、His-CRP、WBC、N;VEGF值与APACHE III具有显著相关性,可作为老年AECOPD患者临床病情严重程度判断及预后的一个重要指标。
Objective To investigate the diagnostic value of vascular endothelial growth factor (VEGF) in elderly patients with AECOPD and its relationship with acute physiology and chronic health status (APACHE III) score. Methods Sixty elderly patients with AECOPD, 30 patients with stable COPD, and 30 healthy controls were enrolled in the study. Twenty-four hours after admission, high-sensitivity C-reactive protein (his-CRP), procalcitonin (PCT) (WBC) and neutrophil percentage (N). The APACHE III was recorded within 24 h of admission and on the 8th day of treatment. The changes of VEGF and APACHE III scores were observed before and after treatment. Results ① Compared with hypersensitivity C-reactive protein, leukocyte, procalcitonin and so on, VEGF is the best one to diagnose AECOPD. ② The values of VEGF (109.16 ± 50.85) and APACHE III (26.45 ± 3.37) after treatment were significantly lower than those before treatment (213.91 ± 72.00), APACHE III (42.35 ± 4.22) (P <0.05) The level was significantly associated with the APACHE III score. Conclusions Serum VEGF is a good indicator in the diagnosis of acute exacerbation of chronic obstructive pulmonary disease, and its discriminant effect is higher than that of PCT, His-CRP, WBC, N. VEGF value has a significant correlation with APACHE III and can be used as a clinical symptom of elderly AECOPD patients Degree of judgment and prognosis of an important indicator.